Active NPI
Jean Charles Erramouspe, O.D.
- Optometrist
- Reno, NV
National Provider Identifier
1316955461
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 561
- Practice address
- 5164 Meadowood Mall Cir. F-109
Reno, NV 89502 - Phone
- (775) 825-1707
- Fax
- (775) 825-1984
- NPI assigned
- Aug 4, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 561 | NV | Primary |
Addresses
Primary practice location
5164 Meadowood Mall Cir. F-109
Reno, NV 89502
Mailing address
PO Box 19164
Reno, NV 89511
Phone (775) 825-1707
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 100510002 | Medicaid | NV |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 561 | NV | MD | Optometrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| H Kenneth Kopolow O.D & Assoc P.C | Optometrist | Past | Accepting new patients |
| Visionworks, Inc | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
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- Las Vegas, NV
- NPI 1336186444
-
- Eyewear Supplier
- Simpsonville, SC
- NPI 1699571166
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1154649600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1582243200000",
"number": "1316955461",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 19164",
"city": "RENO",
"state": "NV",
"postal_code": "89511",
"telephone_number": "775-825-1707",
"fax_number": "775-825-1984"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5164 MEADOWOOD MALL CIR. F-109",
"city": "RENO",
"state": "NV",
"postal_code": "89502",
"telephone_number": "775-825-1707",
"fax_number": "775-825-1984"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ERRAMOUSPE",
"first_name": "JEAN",
"middle_name": "CHARLES",
"name_prefix": "Dr.",
"credential": "O.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-08-04",
"last_updated": "2020-02-21",
"certification_date": "2020-02-21",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "NV",
"license": "561",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "100510002",
"state": "NV"
}
],
"endpoints": [],
"other_names": []
}Other providers in Reno, NV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.